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At least 613 records · Page 34Linked to original sources

PubMed2005

Evaluation of a clinical teaching method involving stories.

A clinical teaching method involving stories was evaluated in this study. A total of 25 ASN and BSN students participated in Phase I evaluation and another 16 ASN students were included in Phase II. Each student created a story about an obstetric or a pediatric topic. The story was then read by the story writer to peers and faculty. The faculty member facilitated dialogues and reflections on the meanings of the story. In Phase I, students offered written responses about the effectiveness of the story teaching. In Phase II, a 5-item questionnaire measured pre- and post-test scores of perceived improvement in five knowledge areas. Results showed that students perceived the story teaching positively because it brought learning to a personal level and facilitated in-depth discussion and critical thinking. Perceived knowledge improvement was evident after the story teaching in nursing interventions, the physiological and psychosocial alterations, legal/ethical/cultural issues, and community resources. In conclusion, this teaching method was acceptable to students and may have contributed to positive learning outcomes.

Adult↗

PubMed2000

The face typicality-recognizability relationship: encoding or retrieval locus?

Using a crossover recognition memory testing paradigm, we tested whether the effects on face recognition of the memorability component of face typicality (Vokey & Read, 1992, 1995) are due primarily to the encoding process occurring during study or to the retrieval process occurring at test. At study, faces were either veridical in form or at moderate (Experiment 1) or extreme (Experiment 2) levels of caricature. The variable of degree of facial caricature at study was crossed with the degree of caricature at test. The primary contribution of increased memorability to increased hit rate was through increased distinctiveness at study. Increased distinctiveness at test contributed to substantial reductions in the false alarm rate, too. Signal detection analyses confirmed that the mirror effects obtained were primarily stimulus/memory-based, rather than decision-based. Contrary to the conclusion of Vokey and Read (1992), we found that increments in face memorability produced increments in face recognition that were due at least as much to enhanced encoding of studied faces as they were to increased rejection of distractor faces.

Adult↗

PubMed1976

Oxygen tension and surface temperature of the endonasal tissues in the goat. Preliminary report.

Measurement of the PO2 in the mucosal cells and at various depths of the lamina propria lining the nasal cavity in five male goats using Silver's special microelectrodes, revealed relative hypoxia in the anterodorsal part of the nasal septum and tips of naso- and maxilloturbinals. In these sites PO2 values varied between 55-65 at the surface and 30-35 in the superficial subepithlial layer while elsewhere in the nose, lip and tongue, PO2 values of 85-90 were obtained. Temperature measurements with the thermistor in two goats yielded readings of 34-34-5 degrees C. in the hypoxic areas against 36-37 degrees C. in the posterior parts, the roof and floor of the nasal cavity. However, the oxygen tension diminished steadily in all areas as the microneedle electrode approached the chondro-osteal tissues but PO2 values of 0-10 in the perichondrium. The significance of these findings in the predilective localization of granulomata and various forms of vasculitis in the anterior endonasal tissues has been discussed.

Animals↗

PubMed2006

The chemically elegant proton pump inhibitors.

Medicinal chemistry instruction at Creighton University is designed to provide an in-depth scientifically grounded and clinically relevant learning experience for pharmacy students. Each topic covered in the 2-semester required course sequence is selected based on the general utility of the compounds in question and/or the therapeutic importance of the drugs in treating life-threatening diseases. All lessons provided to campus- and Web-based students by the author are in the form of a descriptive and conversational narrative and course requirements are in place to assure that students read the lesson prior to the class period in which it is discussed. Learning tools and aids are provided to help students more readily discern the most critical aspects of each lesson, to practice required critical thinking and structure analysis skills, and to self-assess competency in meeting specific learning objectives. This manuscript illustrates this approach by sharing a lesson on the chemistry and clinically relevant structure-activity relationships of proton pump inhibitors.

Education, Pharmacy↗

PubMed2006

Communication in young children with fragile X syndrome: a qualitative study of mothers' perspectives.

PURPOSE: To provide descriptive and qualitative information about communication in young children with fragile X syndrome (FXS) and about how families react to and accommodate communication differences in their children. METHOD: In-depth interviews were conducted with 55 mothers of young children with FXS. Interviewers asked mothers to describe their children's communication, strategies they used to help promote their children's communication, communication-related frustrations, their expectations for their children, and the roles that they perceive for themselves. RESULTS: Over half the children were nonverbal and learning to communicate with augmentative and alternative communication. Mothers reported using strategies that were developmentally appropriate and recommended by early childhood experts, such as reading and talking to their children. Many mothers identified challenges faced in helping their child to communicate, and some cited difficulty obtaining speech-language services as a challenge. Mothers identified their roles as caregiver, teacher, therapist, and advocate. CONCLUSIONS: The perspectives offered by mothers are valuable because they indicate how children with FXS communicate in natural contexts. Information about mothers' expectations and roles may help clinicians to be sensitive to variables that will affect working with young children and their families.

Adult↗

PubMed2002

Energy response of an imaging plate exposed to standard beta sources.

Imaging plates (IPs) are a reusable media, which when exposed to ionizing radiation, store a latent image that can be read out with a red laser as photostimulated luminescence (PSL). They are widely used as a substitute for X-ray films for diagnostic studies. In diagnostic radiology this technology is known as computed radiography. In this work, the energy response of a commercial IP to beta-particle reference radiation fields used for calibrations at the National Institute of Standards and Technology was investigated. The absorbed dose in the active storage phosphor layer was calculated following the scaling procedure for depth dose for high Z materials with reference to water. It was found that the beta particles from Pm-147 and Kr-85 gave 68% and 24% higher PSL responses than that induced by Sr-90, respectively, which was caused by the different PSL detection efficiencies. In addition, normalized response curves of the IPs as a function of depth in polystyrene were measured and compared with the data measured using extrapolation chamber techniques. The difference between both sets of data resulted from the continuous energy change as the beta particle travels across the material, which leads to a different PSL response.

Brachytherapy↗

PubMed1998

Observer differentiation of mechanical defects versus natural dental caries cavitations on monitor-displayed images with imaging plate readout.

OBJECTIVE: The purpose of this study was to compare the ability of dentists to detect mechanically created defects vs natural dental caries cavitations on the proximal surfaces of extracted teeth by means of storage phosphor imaging plate technology. STUDY DESIGN: Fifty-two extracted molar and premolar teeth were blocked into sets for bitewing radiographs through use of the DIGORA digital imaging system. Sixteen natural caries cavities and 28 artificial lesions were present in the 80 proximal surfaces included in the study. A group of 16 dentists assessed proximal lesions on unenhanced images on the monitor and 1 month later on contrast-enhanced images. A different group of 16 dentists assessed proximal lesions on contrast-enhanced images and 1 month later on unenhanced images. The Mann-Whitney U test was used to check for a reading-order effect. The Zelen test of odds ratio was used to test for homogeneity, and the Mantel-Haenszel analysis or stratified logistic regression was used for inference about the common odds ratio. Alpha was set at P < .05. RESULTS AND CONCLUSIONS: With the DIGORA system, there was little difference between the detection rates of mechanical defects and natural carious cavities with unenhanced images, but the mechanical defects were more readily detected when contrast-enhanced images were used. Cavity depth positively affected the odds of diagnosis of lesions, with deeper lesions being more readily detected than more superficial ones irrespective of whether they were natural or artificial. In comparison with findings of previous studies in which film and a charge-coupled device detector were used, the overall detection rate for natural dental caries was remarkably constant across the modalities.

Dental Caries↗

PubMed2006

Characterization of a Methanosarcina acetivorans mutant unable to translate UAG as pyrrolysine.

The methyltransferases initiating methanogenesis from trimethylamine, dimethylamine and monomethylamine possess a novel residue, pyrrolysine. Pyrrolysine is the 22nd amino acid, because it is encoded by a single amber (UAG) codon in methylamine methyltransferase transcripts. A dedicated tRNA(CUA) for pyrrolysine, tRNA(Pyl), is charged by a pyrrolysyl-tRNA synthetase with pyrrolysine. As the first step towards the genetic analysis of UAG translation as pyrrolysine, a 761 base-pair genomic segment in Methanosarcina acetivorans containing the pylT gene (encoding tRNA(Pyl)) was deleted and replaced by a puromycin resistance cassette. The DeltappylT mutant lacks detectable tRNA(Pyl), but grows as wild-type on methanol or acetate. Unlike wild-type, the DeltappylT strain cannot grow on any methylamine, nor use monomethylamine as sole nitrogen source. Wild-type cells, but not DeltappylT, have monomethylamine methyltransferase activity during growth on methanol. Immunoblot analysis indicated monomethylamine methyltransferase was absent in DeltappylT. The phenotype of DeltappylT reveals the deficiency in methylamine metabolism expected of a Methanosarcina species unable to decode UAG codons as pyrrolysine, but also that loss of pylT does not compromise growth on other substrates. These results indicate that in-depth genetic analysis of UAG translation as pyrrolysine is feasible, as deletion of pylT is conditionally lethal depending on growth substrate.

Amino Acyl-tRNA Synthetases↗

PubMed2002

Perceptions of the researcher: in-depth interviewing in the home.

In this paper we explore the home as a setting to collect qualitative data. The text is drawn from a collaborative research initiative that sought to interview people with cardiac disease. The literature pays little attention to the home as a venue for in-depth data gathering and yet from our experience it is very different to other settings. We argue the need for extra consideration to aspects such as trust, self-disclosure and safety, and draw these conclusion from the data gathered in the field.

House Calls↗

PubMed1999

Required training in hospice and palliative care at the University of Maryland School of Medicine.

BACKGROUND: Over a period of four years the authors developed and integrated into the curriculum of their medical school training programs in palliative medicine. Critical required elements in the freshman year focus on attitudes and the physician's role in the care of terminally ill patients and their families. A 16-hour module has been designed to be a required element for junior students. It includes in-depth classroom and experiential training in palliative medicine. The results of the pilot of this module are presented. METHODS: The module consisted of one four-hour half-day session for four consecutive weeks during the ambulatory block in internal medicine. The first half-day class included both lectures and small-group discussions. Pain management, management of non-pain symptoms, and recognition of and basic interventions in spiritual and psychosocial suffering were covered. Required out-of-classroom reading assignments were distributed. The second and third half days were experiential, during which the student, in the company of a hospice nurse, made palliative care evaluations of terminally ill hospice patients. The last half day was a classroom session where the students presented their palliative care plan(s) for the patient(s) they had encountered on half days 2 and 3 to an interdisciplinary team (IDT) of the other students, a hospice medical director, a social worker, a hospice nurse, and a chaplain. Student scores on a 60-item objective test and participation in the IDT meeting were the primary data sources used to evaluate student achievement of the course objectives. RESULTS AND CONCLUSIONS: The majority of students attained the course objectives. Student evaluations of the module were very positive, particularly with regard to the home visits and the need for this training. It is anticipated that the module will be required during the 1999-00 academic year, with each student's performance contributing to his or her final grade in junior medicine.

Curriculum↗

PubMed2005

Development and operation of a pixel segmented liquid-filled linear array for radiotherapy quality assurance.

A liquid isooctane (C(8)H(18)) filled ionization linear array for radiotherapy quality assurance has been designed, built and tested. The detector consists of 128 pixels, each of them with an area of 1.7 mm x 1.7 mm and a gap of 0.5 mm. The small pixel size makes the detector ideal for high gradient beam profiles such as those present in intensity modulated radiation therapy (IMRT) and radiosurgery. As the read-out electronics we use the X-ray Data Acquisition System with the Xchip developed by the CCLRC. Studies concerning the collection efficiency dependence on the polarization voltage and on the dose rate have been made in order to optimize the device operation. In the first tests, we have studied dose rate and energy dependences. Dose rate dependence was found to be lower than 2.1% up to 5 Gy min(-1), and energy dependence lower than 2.5% up to 20 cm depth in solid water. Output factors and penumbras for several rectangular fields have been measured with the linear array and were compared with the results obtained with a 0.125 cm(3) air ionization chamber and radiographic film, respectively. Finally, we have acquired profiles for an IMRT field and for a virtual wedge. These profiles have also been compared with radiographic film measurements. All the comparisons show a good correspondence. The device has proved its capability to verify on-line therapy beams with good spatial resolution and signal-to-noise ratio.

Dose-Response Relationship, Radiation↗

PubMed1999

Ionization chamber, electrometer, linear accelerator, field size, and energy dependence of the polarity effect in electron dosimetry.

Plane-parallel ionization chambers are the instrument of choice for use in electron calibration and dosimetry, but these chambers may exhibit large polarity effects. This study concentrates on measuring the dependence of the polarity error at various mean energies using different linear accelerator, field size, ion chamber, and electrometer combinations. The polarity error was shown to increase for all four ionization chambers as the mean energy at depth decreased, but was always less than one percent at d(max). Polarity error dependence was also observed for similar plane-parallel chambers, varying field sizes, and different linear accelerators, but no polarity error dependence was observed for similar cylindrical chambers and different electrometers. Measurements of the polarity error can be used to develop correction factors for future measurements that will help minimize the time spent performing electron dosimetry and calibrations. These correction factors can be used to calculate the correct reading without the need to reverse the chamber bias, thus reducing the number of measurements required.

Calibration↗

PubMed2000

Accuracy of clinical estimates of intraocular pressure in Chinese eyes.

PURPOSE: To investigate the validity of clinical estimates of intraocular pressure (IOP) in Chinese people. DESIGN: Prospective, cross-sectional, hospital-based in vivo study. PARTICIPANTS: Twenty-three ethnic Chinese adults (aged 35-82 years) undergoing routine phacoemulsification surgery were examined. TESTING: "True" IOP was measured with a solid-state hemodynamic monitor through a cannula in the anterior chamber. IOP was set successively to 10, 20, and 30 mmHg in each subject, using a reservoir of balanced salt solution. Intraocular pressure was simultaneously estimated by use of a hand-held applanation tonometer (Perkin's) and a Tono-Pen. The association between ocular biometric variables and measurement error was examined. MAIN OUTCOME MEASURES: The median of three readings at each IOP level was taken as the IOP estimate of each instrument. Measurement error was calculated as the mean difference (tonometer minus direct measurement). RESULTS: The error for the hand-held applanation tonometer was -1.6, -4.3 and -5.7 at 10, 20, and 30 mmHg, respectively. For the Tono-Pen the measurement error was +0.4, -2.0, and -4.1 at 10, 20, and 30 mmHg, respectively. We could identify no association between measurement error and corneal thickness or curvature, anterior chamber depth, or axial length. CONCLUSIONS: The applanation tonometer and Tono-Pen underestimate the true IOP in Chinese eyes. Error increases as true IOP increases. These tonometers do not give an accurate estimate of IOP in East Asians.

Adult↗

PubMed2002

Fluorescence-guided laser removal of chemically damaged cornea.

PURPOSE: To correlate the observed fluorescence spectrum with the depth of ablation during 193 nm argon-fluoride excimer laser ablation of chemically damaged corneas. SETTING: Laser facility, Cedars-Sinai Medical Center, Los Angeles, California, USA. METHODS: Three cadaver New Zealand white rabbit corneas were exposed to 1 N hydrogen chloride for 10 seconds. The resultant opaque corneas were ablated to perforation using the excimer laser. Laser-induced fluorescence was collected at 45 degrees from incidence and channeled into an ultraviolet-visible spectrometer coupled to an optical multichannel analyzer reading a diode array detector. The detector recorded single-shot fluorescence spectra. The data were examined by principal component analysis, and the evolution of eigenvectors and their weighting coefficients were used to compare data among corneas. The results were correlated with histopathological sections. RESULTS: The eigenvalues of 3 principal components corresponded to 88.9%, 10.0%, and 0.4% of the data in acid-burned corneas. Compared to that in undamaged corneas, more information was stored in the first principal component and the third eigenvector was distinctly altered. Acid-scarred tissue blue shifted the dominant fluorescence peak compared to that in normal corneal tissue. CONCLUSIONS: After severe hydrogen chloride burn to the rabbit corneal surface, monitoring the dominant peak wavelength shift of excimer-laser-induced fluorescence can detect the transition between severely acid-damaged and underlying tissue.

Animals↗

PubMed1996

A review of national guidelines on the clinical use of ambulatory blood pressure monitoring.

REVIEW IN DEPTH: In recent years noninvasive ambulatory blood pressure monitoring has begun to find acceptance as a clinically diagnostic tool. Several national organizations, from Brazil, France, Italy, Switzerland, and the USA, have published guidelines concerning when and how it should be used. With one exception, all advocate its clinical use in selected categories of patients, including those with 'white-coat' hypertension, autonomic dysfunction, episodic hypertension, and refractory hypertension. None recommends it as a routine test. Monitoring for 24 h is generally recommended, with readings taken every 15-30 min. The area of greatest disagreement among the guidelines is the upper limit of normal ambulatory blood pressure.

Journal Article↗

PubMed1992

Hypertrophic scar: an interruption in the remodeling of repair--a laser Doppler blood flow study.

Soft-tissue dermal loss does not regenerate; instead, it is replaced with scar. The extent of scarring is directly related to the severity of tissue loss (in terms of volume and depth). Commonly, an acute dermal loss will heal with excessive scar, hypertrophic scar. A hypertrophic scar is elevated but is contained within the boundaries of the initial injury. Hypertrophic scars have a reddish appearance, indicating an elevated local circulation. A laser Doppler blood flow monitor was employed to measure blood flow changes in healed wounds. It was speculated that local circulation in a developing hypertrophic scar would be elevated. Patients with recently healed wound sites were monitored and exhibited an average blood flow reading of 365 +/- 325 mV (n = 131). This average value, ranging from 98 to 1450 mV, was 18 times greater than the average reading from normal skin, which was 43 +/- 13 mV (n = 212). Blood flow declined to 32 +/- 21 mV (n = 7) at 16 to 18 weeks (74 percent of normal skin values) in healed wounds that developed normal scar. However, a closed wound that developed into a hypertrophic scar had a blood flow reading of 148 +/- 78 mV (n = 59) at 16 to 18 weeks. This value was three times greater than in normal skin and four times greater than in normal scar. At 38 to 50 weeks postinjury, hypertrophic scar remained elevated (102 +/- 34 mV; n = 10). Hypertrophic scars sustain an elevated blood flow.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗

PubMed1984

Toward the separation of memory and hope: applications of psychoanalysis to art in the writings of Martha Wolfenstein.

My aim in the foregoing article has been to demonstrate, by a brief study of Martha Wolfenstein's selected works, the value of applying clinically derived interpretative schema to the realm of art. It has not been possible here to recapitulate in all its intricacy the argument of each of Wolfenstein's papers under discussion; only a thorough reading of her papers themselves can provide that measure of detail. Beginning with an overview of Wolfenstein's theoretical contributions to the theme of parental loss in childhood, I have shown how her psychoanalytic understanding of this theme is brought to bear on the artistic products of both a poet and a painter who were themselves in childhood bereaved, as were the patients in Wolfenstein's clinical case studies. I hope in so doing to have conveyed a sense of the range and depth of Wolfenstein's work. I believe her work offers us a legacy not only substantive but paradigmatic, a legacy of humane concerns, passionate scholarship, remarkable ingenuity, and stunning leaps of insight.

Humans↗

PubMed2002

Binocular function of the patient with the refractive multifocal intraocular lens.

PURPOSE: To investigate binocular function in bilateral and unilateral implantation of the refractive multifocal intraocular lens (IOL). SETTING: Department of Ophthalmology, Musashino Red Cross Hospital, Tokyo, Japan. METHODS: Sixty-six eyes of 40 patients were enrolled in this retrospective study. Twenty-six were implanted bilaterally and 14 were implanted unilaterally with the 3-zone refractive multifocal IOL. Distance visual acuity, near visual acuity, and contrast sensitivity were measured monocularly and binocularly. Stereopsis, aniseikonia, and the use of spectacles were also evaluated. RESULTS: There were no significant between-group differences in monocular and binocular visual acuity. In the bilateral group, 85% had 60 seconds or more of stereopsis; in the unilateral group, 43% had the same level of stereopsis (P =.009). Ninety-two percent and 21%, respectively, had no aniseikonia (P =.001), and 89% and 50%, respectively, did not use spectacles (P =.012). In the unilateral group, in 4 of 5 cases in which surgery was performed in the dominant eye, spectacles were not required; in 9 cases in which surgery was performed in the nondominant eye, 78% used spectacles for reading (P =.063). CONCLUSIONS: Bilateral implantation of the multifocal IOL appeared to lead to better results than unilateral implantation. However, our results suggest that the patient may be satisfied with unilateral implantation when it is performed in the dominant eye.

Adult↗